The use of sensory electrical stimulation for pressure ulcer prevention

Pressure ulcer prevention is critically important for many people with reduced mobility. The authors investigated whether sensory (sub-motor-threshold) electrical stimulation (ES) may provide a convenient preventive intervention. A double-blinded, repeated measures study design was used to test the hypothesis that repeated use of sensory surface ES improves tissue health status in individuals with motor paralysis. Six adult males with complete spinal cord injury (SCI) were randomly assigned to treatment or control groups. The treatment group received the ES intervention, whereas the control group received a control sham intervention. Repeated tissue health assessments included transcutaneous oxygen tension (T(c)PO(2)), interface pressure mapping, and gluteal computed tomography (CT) studies. An initial increase in T(c)PO(2) following use of subthreshold ES was observed but was not sustained at follow-up. No statistically significant changes before and after treatment were found in regional T(c)PO(2), gluteal muscle area or pressure distribution. Thus subthreshold ES does not appear to have any sustained effects on tissue health status indicative of reduced pressure ulcer risk for individuals with SCI. This implies that a contractile muscle response is critically important and further that subthreshold ES is unlikely to prevent pressure ulcers. Further studies are needed to find solutions for preventing pressure ulcers in high-risk populations.